Visitors in a Hollywood shopping district wore masks earlier this month. Los Angeles County is currently averaging over 1,000 new cases per day.
Credit…Marcio Jose Sanchez/Associated Press

Los Angeles County announced Thursday that it will require masks to be worn inside regardless of vaccination status, as the highly contagious Delta variant spreads throughout California.

Public health officials in L.A. County had already been urging residents to wear masks indoors. The mandate will begin Saturday night, just before midnight.

Only weeks ago, on June 15, Californians celebrated their state’s reopening as most restrictions were lifted. A statewide mask mandate was relaxed for vaccinated people.

The Delta variant is extremely contagious, scientists say, and may cause more severe illness. Dr. Anthony S. Fauci, the nation’s top infectious disease doctor, has described it as “the greatest threat in the U.S. to our attempt to eliminate Covid-19.” The tens of millions of Americans who are vaccinated are largely protected from the virus, including the Delta variant, scientists have said.

The C.D.C. says that the variant is now responsible for over half of all new cases in the United States. While cases are rising nationally, overall, the average numbers of new virus cases and deaths, as well as hospitalizations, are significantly down from the devastating peaks during previous national surges.

Daily case numbers have increased at least 15 percent over the last two weeks in 49 states, including 19 states that are reporting at least twice as many new cases a day. Full-fledged outbreaks have emerged in a handful of places with relatively low vaccination rates, including Arkansas, Missouri, Louisiana and Nevada.

L.A. County is averaging over 1,000 new cases per day, a 279 percent increase from the average two weeks ago, according to a New York Times database. By comparison, the county averaged at least 13,000 new cases or higher through much of December and January. Hospitalizations are up 27 percent over the past two weeks.

Dr. John Swartzberg, an infectious disease specialist and clinical professor emeritus at the University of California, Berkeley School of Public Health, said recently that he didn’t think the Delta variant was a particular threat in Los Angeles, where huge swaths of the population have already been infected with the virus, and vaccination rates are relatively high.

Still, other experts have noted that there are millions of Californians — including children and Black and Latino essential workers — who have not yet been vaccinated. Over 51 percent of California’s total population has been full vaccinated and 52 percent of L.A. County residents have received both doses, according to a New York Times database.

“These increases in cases and hospitalizations are occurring among the unvaccinated,” said Dr. Robert Kim-Farley, a professor of epidemiology at the University of California, Los Angeles Fielding School of Public Health. “This virus, if you are not vaccinated, will find you.”

Dr. Anne Rimoin, a professor of epidemiology at the University of California, Los Angeles Fielding School of Public Health, said the new mandate made sense. “A universal mask mandate that is not based on vaccination status makes it very possible to implement,” she said. “Having to wear a mask indoors, for everyone, is simple and efficient.”

California has said that it would continue requiring masks in public schools, a policy that has been in place since February and was reiterated in new guidance released for K-12 public schools.

That goes against guidance from the Centers for Disease Control and Prevention, which has called for a full return to classrooms in the fall and recommended that masks be optional for fully vaccinated students and staff.

Also on Thursday, the University of California announced that students and personnel must require proof of vaccination two weeks before returning to campus for the fall term. Students who don’t provide proof of vaccination or who haven’t applied for an exception or deferral by that date may have their registration put on hold.

The spread of the Delta variant has prompted a vigorous new vaccination push from the Biden administration, and federal officials are planning to send medical teams to communities facing outbreaks that now seem inevitable.

A Covid patient at a hospital in Johannesburg on Saturday. The effect of the Delta variant in Africa has seen hospitalizations rise, while deaths have surged 43 percent in the past week on the continent.
Credit…Sumaya Hisham/Reuters

NAIROBI, Kenya — The coronavirus is sweeping across Africa at a pace not seen before in the pandemic, the World Health Organization said on Thursday, highlighting the severity of a third wave driven by the spread of the Delta variant.

One million Covid infections were reported on the continent in the past month alone, pushing the overall caseload to six million, according to the W.H.O., which urged wealthier nations to distribute more vaccine doses.

Over a month, that is the fastest growth of new cases so far in Africa, Dr. Matshidiso Moeti, the health organization’s director for the continent, said in an online news conference. By comparison, it previously took three months to go from four million to five million total cases.

“Africa’s third wave continues its destructive pathway, pushing past yet another grim milestone,” Dr. Moeti said.

The situation in at least 18 African countries paints a grim picture, and with limited vaccine supplies, many nations on the continent have been unable to contain a new surge in infections. Unlike in places like the United States or Europe, where inoculations are relatively widespread, the effect of the Delta variant in Africa has seen hospitalizations rise, while deaths have surged 43 percent in the past week on the continent.

Adding to the dangers posed by the virus are additional risks faced by people living with H.I.V., according to a new study. Sub-Saharan Africa is home to two-thirds of H.I.V. cases worldwide.

The Delta variant has been detected in 21 of Africa’s 54 countries, with Algeria, Malawi and Senegal among the countries experiencing a surge in infections.

The resurgence has pushed several governments to impose new lockdown measures, including restricting movement between cities, extending curfew hours, and shutting down schools.

The coronavirus has left already-fragile health systems even more strained, overwhelming doctors and nurses and draining limited oxygen supplies. At least five countries have reported shortages in intensive care beds, including South Africa, which has been particularly badly hit. Hospital admissions have increased in 10 others.

A W.H.O. survey of six African countries during the current wave showed that they were producing only a third of the medical oxygen they needed. Dr. Moeti said that monoclonal antibodies, which have been recommended for high-risk patients, were out of reach for many Africans.

Even as cases rise, only about one percent of people in Africa have been fully immunized. And of the continent’s population of more than a billion, just 52 million have received even one dose of a vaccine — that accounts for only about 1.6 percent of the 3.5 billion who have been vaccinated worldwide, according to the W.H.O.

Dr. Jean-Jacques Mbungani Mbanda, the minister of public health in the Democratic Republic of Congo, urged wealthy nations to step up vaccine donations. Congo, where dozens of lawmakers have died after contracting the virus, has faced a severe wave, with more than 70 percent of the sequenced cases attributed to the Delta variant, Dr. Mbanda said on Thursday.

“The vaccine is the only way to reduce the extent of deaths,” he added. Only 2.2 percent of Congo’s nearly 90 million people has received at least one dose of a coronavirus vaccine, according to a New York Times tracker. To ease the impact of the pandemic, African leaders, meeting in Ivory Coast’s commercial capital Abidjan, on Thursday called for a three-year $100 billion infusion of emergency funding from the International Development Association, the World Bank’s fund for the world’s poorest nations.

On Thursday, W.H.O. officials also pressed wealthier nations to steer away from considering booster shots and instead focus on their global responsibilities to ensure fair access to coronavirus vaccines.

The pandemic is “nowhere near finished,” said Dr. Tedros Adhanom Ghebreyesus, the organization’s director general.

Anna Schaverien contributed reporting.







Tech Companies ‘Enabled Misinformation,’ Surgeon General Says

The U.S. surgeon general, Dr. Vivek Murthy, called for a national effort to stop the spread of misinformation about Covid-19 vaccines and accused tech and social media companies of exacerbating the problem.

Today, I issued a surgeon general’s advisory on the dangers of health misinformation. Surgeon general advisories are reserved for urgent public health threats. And while those threats have often been related to what we eat, drink and smoke, today, we live in a world where misinformation poses an imminent and insidious threat to our nation’s health. Health misinformation is false, inaccurate or misleading information about health, according to the best evidence at the time. And while it often appears innocuous on social media apps and retail sites or search engines, the truth is that misinformation takes away our freedom to make informed decisions about our health and the health of our loved ones. During the Covid-19 pandemic, health misinformation has led people to resist wearing masks in high-risk settings. It’s led them to turn down proven treatments and to choose not to get vaccinated. This has led to avoidable illnesses and death. Simply put, health information has cost us lives. Modern technology companies have enabled misinformation to poison our information environment with little accountability to their users. They’ve allowed people to intentionally spread misinformation, what we call disinformation, to have extraordinary reach. They’ve designed product features such as like buttons that reward us for sharing emotionally charged content, not accurate content. And their algorithms tend to give us more of what we click on, pulling us deeper and deeper into a well of misinformation. Now we need an all-of-society approach to fight misinformation. And that’s why this advisory that I issued today has recommendations for everyone.

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The U.S. surgeon general, Dr. Vivek Murthy, called for a national effort to stop the spread of misinformation about Covid-19 vaccines and accused tech and social media companies of exacerbating the problem.CreditCredit…Doug Mills/The New York Times

President Biden’s surgeon general on Thursday used his first formal advisory to the United States to deliver a broadside against tech and social media companies, which he accused of not doing enough to stop the spread of dangerous health misinformation — especially about Covid-19.

The official, Dr. Vivek Murthy, declared such misinformation “an urgent threat to public health.” His pronouncement came just days after representatives from his office met with Twitter officials, according to a person with knowledge of the matter who spoke on condition of anonymity.

Surgeons general have traditionally used advisories — short statements meant to call Americans’ attention to a public health issue and provide recommendations for addressing it — to talk about such health matters as tobacco use, opioid addiction, suicide prevention and breastfeeding.

But Dr. Murthy’s advisory, a 22-page report with footnotes, had a more political context. Fox News hosts like Tucker Carlson and Laura Ingraham, along with their guests, are among those who have been casting doubt on Covid-19 vaccines, which studies show are highly effective at preventing death and hospitalization from the disease.

Dr. Murthy couched his criticism of tech companies in a broader declaration about the dangers of inaccurate and false information about health, including misinformation about coronavirus vaccinations. He called on all Americans to take pains to share accurate information, and said the United States needs “an all-of-society approach” to combat the problem.

But at a news briefing Thursday, Dr. Murthy joined the White House press secretary, Jen Psaki, and made clear that tech and social media companies were his main target, saying they have a singular responsibility to be more aggressive in fighting misinformation and citing Facebook by name.

“Modern technology companies have enabled misinformation to poison our information environment, with little accountability to their users,” Dr. Murthy said.

“We expect more from our technology companies,” he added. “We’re asking them to operate with greater transparency and accountability. We’re asking them to monitor misinformation, more closely.”

Facebook, Twitter and YouTube all said Thursday that they had taken steps to crack down on misleading health information, in keeping with their coronavirus misinformation policies. All three said they had introduced features to point users to authoritative health sources on their platforms.

Private Brandon Ober administering a dose of a Covid-19 vaccine to Sgt. Jeff Walston at Fort Bragg, in North Carolina, in February. Fort Rucker, in Alabama, is requiring all uniformed service members who do not wear masks to show proof of vaccination.
Credit…Kenny Holston for The New York Times

About 68 percent of members of the U.S. military have had at least one dose of a Covid vaccine, but given that only full vaccination affords significant protection against the more infectious Delta variant surging in parts of the United States, American commanders are seeking new ways to pressure, entice and cajole service members to get their shots.

Now, Fort Rucker in Alabama has become the first military base in the United States to require that unmasked uniformed service members provide proof of vaccinations.

As in other states that have low overall vaccination rates, coronavirus cases are rising sharply in Alabama. Only 33 percent of the state’s population is fully vaccinated, one of the lowest proportions in the country, and cases have shot up 133 percent over the last two weeks, according to a New York Times database, reaching a daily average of more than 500. Hospitalizations have risen 39 percent over two weeks.

The situation has added urgency to military leaders’ battle against vaccine misinformation and hesitancy in the ranks.

“The big difference is going to be that if you are not wearing a mask, the leadership will be able to ask you, ask soldiers, to prove that they’ve been vaccinated by showing their vaccination card,” said Major Gen. David Francis, the commanding general of Fort Rucker, in a video posted July 12 on Fort Rucker’s Facebook page.

President Biden could legally require members of the military to get vaccinated even though the vaccines in use in the United States — those made by Pfizer-BioNTech, Moderna and Johnson & Johnson — have only emergency authorization from the Food and Drug Administration. Mr. Biden has steadfastly refused to exercise that power even amid the spread of the Delta variant.

And some military leaders insist that the lack of full F.D.A. approval prevents them from requiring that Covid shots join myriad other compulsory vaccines for service members.

There are about 5,000 uniformed personnel assigned to Fort Rucker. Many larger bases, like Fort Hood in Texas, require all service members to wear masks indoors, but have areas, like specified gyms, where those who have been vaccinated may congregate without masks.

More than 80 percent of active-duty service members are under 35, a group that has led resistance among civilians too. The vaccination rates vary by service branch. For example, 77 percent of active-duty members in the Navy have had at least one shot, Pentagon officials said recently, while in the Marine Corps, that number is 58 percent.

Dennis Shaffer getting a Covid-19 vaccination at a clinic in Springfield, Mo., on Monday. The vaccines have been found effective against the Delta variant.
Credit…Nathan Papes/The Springfield News-Leader, via Associated Press

Reports of new coronavirus cases are rising again across the United States, a discouraging trend fueled by the spread of the Delta variant and the sputtering vaccination campaign.

The country’s outlook remains far better than at previous points in the pandemic: Nearly half of all Americans are fully vaccinated, cases and hospitalizations remain at a fraction of their peak and deaths are occurring at some of the lowest levels since the early days of the pandemic.

Yet infections are rising in almost every state. Daily case numbers have increased at least 15 percent over the last two weeks in 49 states, including 19 states that are reporting at least twice as many new cases a day. Full-fledged outbreaks have emerged in a handful of places with relatively low vaccination rates, including Arkansas, Missouri, Louisiana and Nevada.

“The Delta variant is gaining ground,” Gov. Asa Hutchinson of Arkansas told residents as he lamented his state’s low vaccine uptake and sudden spike in cases, from fewer than 200 new infections a day in early June to more than 1,000 a day. “It’s an urgent moment because the solution is available. People are always asking me, ‘How do you protect yourself?’ Get the vaccination.”

The tens of millions of Americans who are vaccinated are largely protected from the virus, including the Delta variant, scientists have said. And in much of the country, especially the Northeast, the Upper Midwest and the West Coast, case rates remain relatively low. Vermont, the state with the highest vaccination rate, is averaging 11 new cases a day.

Still, less than a month after reports of new cases nationally bottomed out at around 11,000 a day, virus cases are increasing again, with about 26,000 new cases a day. Hospitalizations have also started to rise, though at a slower rate.

Intensive care beds in hospitals have become scarce in parts of Missouri, where officials in Springfield on Wednesday asked for an alternative care site. In Mississippi, where cases are up 70 percent over the last two weeks, health officials have urged older adults to avoid large indoor gatherings even if they have been vaccinated. And in Louisiana, which has the country’s second-lowest vaccination rate, the average daily caseload has doubled since the start of July.

“The data are very clear,” said Dr. Joseph Kanter, Louisiana’s state health officer. “All people in Louisiana, especially those who are not yet vaccinated, should know they are now at increased risk of exposure to Covid-19 due to the more transmissible Delta variant, and they should consider their personal risk and their family’s risk.”

The disheartening pattern comes as the vaccine effort, which has become entangled in partisan politics, has largely stalled. About 550,000 people are receiving a vaccine each day, down from 3.3 million shots a day during an April peak.

Even in places that have not yet seen a significant uptick, governors and public health officials have urged vaccine holdouts to get a shot and protect themselves from Delta.

“I hope and pray that it doesn’t come to West Virginia and just absolutely runs across our state like wild,” said Gov. Jim Justice, whose state has recorded relatively few cases recently but has a low vaccination rate. “But the odds are it will.”

A Canadian ban on cruise ships will end earlier than expected, after a drop in Covid cases in the country.
Credit…Becky Bohrer/Associated Press

The beleaguered cruise ship industry could see some relief in Canada this fall as the nation’s government prepares to welcome vessels back on its waters earlier than expected.

As Canada grappled with a second wave of Covid infections in the winter, the government extended previous bans for cruise ships and Arctic recreational boats until February 2022. On Thursday, however, Omar Alghabra, the federal transport minister, announced that the ban will be lifted earlier, on November 1. The announcement comes amid a drop in the number of cases in Canada. They fell 27 percent over the last two weeks, according to a New York Times tracker.

Cruise ship operators will still be required to comply with public health orders. And, for the time being, the government is still advising citizens to avoid cruise travel outside the country altogether.

About 30,000 jobs are connected to Canada’s $3 billion cruise ship industry, a news release announcing the change noted.

The Canadian ban had also posed a hurdle for cruise companies in the United States. Ships heading to Alaska from other states typically used to stop at Canadian ports, as required in many cases under maritime law, which was impossible under the ban. A law passed in the U.S. in May allowed the American ships to bypass the requirement.

The changes in the Canadian policy surrounding cruises come as the tourism industry picks up following pandemic closures, as provinces ease certain restrictions. Ontario plans to bring back various indoor activities Friday, including dining, sports and museums.

The Canadian government dropped a 14-day quarantine requirement for citizens and permanent residents flying in from abroad last month. The policy included a controversial directive to stay in a quarantine hotel pending results of a Covid-19 test taken at the airport.

Seventy percent of Canadians have at least one dose of the Covid-19 vaccine, and 46 percent are fully vaccinated, according to a New York Times tracker.

The Detroit-Windsor Tunnel in March 2020.
Credit…Paul Sancya/Associated Press

The mayor of Windsor, Ontario, said the Canadian government had blocked his plan to vaccinate residents inside the tunnel that connects his city with Detroit, using some of Michigan’s surplus, soon-to-expire Covid-19 vaccine doses.

It was an ambitious idea: Since Canadian officials wouldn’t allow U.S. vaccines into the country, American pharmacists would come to the edge of the U.S. border inside the Detroit-Windsor Tunnel, which connects Windsor with Detroit, and jab the vaccine into the arms of Canadians on the other side.

The plan, which was reported by The Detroit Free Press, was the brainchild of Drew Dilkens, the mayor of Windsor. He said in an interview on Thursday that medical professionals in Detroit had told him they were tossing extra vaccines as the demand for the shots in the United States slowed.

Michigan has scrapped nearly 150,000 unused vaccine doses since December, said Lynn Sutfin, a spokeswoman for the state’s Department of Health and Human Services. In addition to looming expiration dates, she said, doses were also discarded because of broken syringes or vials.

The Canadian government has not allowed those surplus vaccines to enter the country, so Mr. Dilkens figured his tunnel plan would keep the doses in Michigan and his residents in Canada. He even arranged for a white line to be painted along the border in the tunnel.

“When the Canadians go down, their feet would stay on the right side of the line,” he said, “and the United States folks, their feet stand on the left.”

But the Canada Border Services Agency denied the request, saying in a letter last month that closing the tunnel for the proposed vaccination effort could disrupt trade and would have “significant security implications.”

Canada had lagged behind the United States in distributing vaccines, but it has recently caught up. According to the government’s health database, nearly 68 percent of Canadians have received at least one dose of a Covid-19 vaccine, and nearly 36 percent have been fully vaccinated. In the United States, where demand for vaccines has cooled in recent weeks, nearly 56 percent of Americans have received at least one dose and just over 43 percent are fully vaccinated, according to a Times database.

Street vendors in Port-au-Prince, the capital of Haiti, on Monday. The country is one of only a handful worldwide that are yet to begin a Covid vaccination program.
Credit…Federico Rios for The New York Times

A shipment of 500,000 Covid vaccine doses from the United States arrived in Haiti on Wednesday, the first shots to reach a nation thrown into turmoil after the assassination of President Jovenel Moïse.

The donation is part of the Biden administration’s effort to bolster lagging vaccination campaigns in the world’s poorer countries, and will be distributed by Covax, the global vaccine-sharing effort, according to a statement by the Pan American Health Organization, part of the World Health Organization.

“The arrival of these vaccines is quite promising and now the challenge is to get them to the people that need them the most,” the P.A.H.O. director, Carissa F. Etienne, said in the statement.

Haiti is one of a handful of countries worldwide, and the only one in Latin America or the Caribbean, that have yet to begin a Covid vaccination program, leaving it at risk as the highly infectious Delta variant circulates the globe. The country has recorded fewer than 20,000 coronavirus cases and 487 deaths, according to New York Times data, but experts believe that number to be an undercount because of low levels of testing.

Marie Gréta Roy Clément, Haiti’s public health minister, said that the doses provided by the United States would be administered free of charge, but she did not specify who would receive the shots first. The U.S. shipment was of the Moderna vaccine, The Associated Press reported.

“This first allocation of vaccines puts an end to a long period of waiting,” Dr. Clément said, “not only for the Haitian population, but also for the people of the region who were very concerned that Haiti was the only country in the Americas that had not yet introduced the Covid-19 vaccine.”

Even before the president’s assassination on July 7, political instability and a lack of resources were hampering Haiti’s response to a new outbreak of the virus. Last month, administrators at a hospital outside Port-au-Prince, the capital, turned away patients because its wards were full. Hospitals have added beds, but doctors warn that there is not enough medical oxygen to treat patients if cases rise further.

Officials said that the United States would send more vaccines to Haiti soon, as the Biden administration speeds up the delivery of 12 million doses it has pledged for countries in the Caribbean and Latin America. About four million doses have been delivered so far, to Bolivia, El Salvador and Honduras, according to the Pan American Health Organization.

A line for polio shots in Chennai, India, in January. The most significant disruptions to childhood vaccinations were reported in countries in Southeast Asia and the Eastern Mediterranean.
Credit…Arun Sankar/Agence France-Presse — Getty Images

About 23 million children missed out on basic childhood vaccines last year, the World Health Organization and UNICEF said on Thursday, warning about a devastating consequence of the Covid-19 pandemic for routine health services.

The number was the highest since 2009, according to the organizations, and mostly affected children living in remote or deprived areas, highlighting the widening gaps in vaccine access that the pandemic has reinforced.

As some Western countries have recommended vaccinating children against the coronavirus, the W.H.O. and UNICEF warned that countless other children around the world were at risk because of a lack of routine immunizations against diseases like polio, measles and meningitis.

“Multiple disease outbreaks would be catastrophic for communities and health systems already battling Covid-19, making it more urgent than ever to invest in childhood vaccination and ensure every child is reached,” W.H.O.’s director general, Tedros Adhanom Ghebreyesus, said in a statement.

The number of children who did not receive their first vaccinations for preventable diseases increased in all regions, with the most significant disruptions reported in countries in Southeast Asia and the Eastern Mediterranean.

India, which has faced one of the world’s worst coronavirus outbreaks, has been hit especially hard by the decline in vaccinations, according to data provided by the W.H.O. and UNICEF. More than three million children in India did not receive a first dose of the diphtheria-tetanus-pertussis vaccine, known as DTP-1, in 2020, up from 1.4 million in 2019. That marked a troubling reversal for a country that had significantly increased the rate of childhood immunizations across its vast population in recent years, experts said.

Other countries with the greatest increases of children who missed immunizations include Indonesia, Pakistan, the Philippines, Mexico and Mozambique.

“These are alarming numbers, suggesting the pandemic is unraveling years of progress in routine immunization and exposing millions of children to deadly, preventable diseases,” said Seth Berkley, the chief executive of Gavi, the Vaccine Alliance, a public-private partnership that helps provide vaccines to developing countries.

Global vaccination rates for children against diseases like diphtheria, tetanus, and measles had already plateaued for years before the pandemic, the W.H.O. said. School closures and the redirection of resources to tackle Covid-19 further disrupted vaccine services, and fears of being infected with the coronavirus left people reluctant to bring their children for immunizations, the organizations added.

In addition to the disruptions in routine immunization efforts, mass vaccination campaigns for diseases such as measles, polio and yellow fever are currently postponed in more than 40 countries, putting millions of children at risk, the report said.

“This is a wake-up call,” Dr. Berkley said. “We cannot allow a legacy of Covid-19 to be the resurgence of measles, polio and other killers.”

Healthcare workers assisted coronavirus patients at a makeshift hospital in Johannesburg, South Africa, last week. Some countries in Africa that are battling a surge in coronavirus cases also have high numbers of people with H.I.V.
Credit…Sumaya Hisham/Reuters

People living with H.I.V. are more likely to become severely ill with Covid-19 and more likely to die if hospitalized than others infected with the coronavirus, according to a large new study. Nearly half of H.I.V.-infected men older than 65 who are hospitalized for Covid may die, the study found.

The results, released ahead of an AIDS conference in Berlin, suggest that people with H.I.V. should be first in line for vaccines, along with older adults and others with weak immune systems, scientists said.

The data is especially pressing because many countries with high numbers of people with H.I.V. are battling surges of the coronavirus, fueled by the contagious Delta variant and a dearth of vaccines. Many of those countries are in Africa, where the virus is moving at a pace not seen before in the pandemic, the World Health Organization said on Thursday. The organization said a million cases were reported on the continent in the past month alone, pushing Africa’s overall caseload to six million.

About 95 percent of the people with H.I.V. included in the analysis were from sub-Saharan Africa, which is home to two-thirds of H.I.V. cases worldwide.

“The strength of this analysis is that we report data from the continent where the H.I.V. burden actually is occurring,” said Dr. Silvia Bertagnolio, an H.I.V. researcher at the World Health Organization who led the study.

Dr. Bertagnolio and her colleagues analyzed anonymized clinical data for 268,412 people hospitalized with Covid that was reported to the W.H.O. from health facilities and national health registries in 37 countries from January 2020 to April 2021.

More than one-third of patients with H.I.V. were severely ill at the time of admission, and nearly one in four of those who were hospitalized for Covid died. The risk of death in those older than 65 was higher still, and highest for older men.

After adjusting for age, sex, disease severity and the presence of other conditions, the researchers estimated that H.I.V. infection increases the odds of dying from Covid by 30 percent.

The result contradicts findings from several smaller studies earlier in the pandemic that suggested that H.I.V. infection has no bearing on a person’s risk of severe illness or death from the coronavirus. But the new study is more biologically plausible than that earlier research, given H.I.V.’s ability to disrupt immune defenses, experts said.

“H.I.V. knocks out all the brakes on the immune system, and as a consequence you get this inflammatory response that’s robust and sustained — and now you got Covid on top of that,” said Dr. Steven Deeks, an H.I.V. expert at the University of California, San Francisco.

Waiting outside a vaccination center in Sydney, Australia, this month. An outbreak in the city has swelled to 900 cases.
Credit…Jenny Evans/Getty Images

Politicians and medical experts in Australia are trading blame for a slow vaccine rollout as the country struggles to contain a coronavirus outbreak in Sydney, its biggest city.

Only about 9.5 percent of Australia’s population of 26 million has been fully vaccinated, with 27 percent of people having had at least one dose, according to New York Times data — figures that lag behind many other richer nations. The rollout of doses has been hampered by shifting advice about the AstraZeneca vaccine, the only one manufactured domestically, which the authorities currently recommend only for those over 60. People under 40 are not yet eligible to receive the Pfizer vaccine, the only alternative, because of supply shortages.

In radio interviews on Wednesday and Thursday, Prime Minister Scott Morrison blamed the sluggish rollout on Australia’s vaccine advisory body, saying its “cautious” guidance had “put us behind.”

The body, a panel of health experts known as the Australian Technical Advisory Group on Immunization, issued recommendations beginning in April that younger people should wait until the Pfizer vaccine was available, because of a very small risk of blood clots connected to the AstraZeneca shots. On Tuesday, the group revised its advice, saying that during an outbreak, when the supply of Pfizer was low, people should consider getting the AstraZeneca shots despite the rare clotting risk.

Mr. Morrison said that the group’s initial advice constrained use of the AstraZeneca vaccine, which Australia had invested in most heavily, and was based on the assumption that case numbers in the country would remain low. “I never made that assumption,” he said.

The advisory group said in response that its role was only to provide guidance and that the federal government remained responsible for decision making.

The finger-pointing was escalating as an outbreak in Sydney swelled to 900 cases, with the lockdown in the state of New South Wales, which includes the city, stretching into a third week. On Wednesday, the state’s premier, Gladys Berejiklian, said that case numbers were “stabilizing.” But officials in Australia’s second-biggest state, Victoria, which includes Melbourne, announced a five-day lockdown after a cluster of infections linked to the Sydney outbreak grew to 18 people. Three of them were suspected to have been infected at a sports event over the weekend attended by tens of thousands of people. More than 10 million in Australia are now under lockdown.

Mr. Morrison’s government has also faced criticism for being slow to procure other vaccines. Australia is set to receive 40 million Pfizer doses by the end of the year, with about three-quarters of those yet to arrive. The government announced last week that the delivery of some of the anticipated doses would be brought forward to August, from September.

Opposition politicians intensified their attacks after it was reported over the weekend that a former prime minister, Kevin Rudd, had called the chief executive of Pfizer in a personal capacity to lobby for more doses, at the request of business leaders. Mr. Morrison’s government responded by saying that it had been communicating with Pfizer’s Australia chief of operations.

Mr. Morrison has also argued that supply chain delays — such as Italy’s blocking AstraZeneca doses bound for Australia earlier this year — and vaccine misinformation spread by some lawmakers hampered the provision of vaccines.

A man waiting to fill empty oxygen canisters outside a factory in Mandalay on Wednesday, in defiance of an order by Myanmar’s military that denies oxygen to private citizens.
Credit…Agence France-Presse — Getty Images

As the Delta variant of the coronavirus rampages through Myanmar, the military, which seized power in a February coup, has ordered that lifesaving oxygen be denied to private clinics, according to medical workers. The clinics are staffed largely by doctors who oppose the army’s takeover and refuse to work in state hospitals. Basic medical care for Covid patients has been turned into an illegal act, said Dr. Min Han, a doctor at a private clinic.

The military has also prevented people from buying supplies from oxygen producers, which it accuses of price-gouging, forcing desperate family members to defy the army in order to save sick relatives. And it has stopped charities from giving oxygen to people who need it, witnesses and charity workers said.

This week, soldiers in the city of Yangon fired into a crowd of people lined up to buy oxygen tanks, witnesses said.

Doctors accuse the military of trying to ensure that the scarce supply of oxygen is funneled to military hospitals, which cater to army families.

Denying oxygen to private clinics and citizens has prematurely ended hundreds of lives, medical workers say, adding a cruel political dimension to an escalating health crisis. Thousands more are at imminent risk of dying, they say. And with the junta having apparently reserved much of the vaccine supply for its loyal ranks, there is little hope that Myanmar’s coronavirus outbreak, by far its worst yet, will end anytime soon.

“An explosion of Covid cases, including the Delta variant, the collapse of Myanmar’s health care system, and the deep mistrust of the people of Myanmar of anything connected to the military junta are a perfect storm of factors that could cause a significant loss of life in Myanmar without emergency assistance by the international community,” Tom Andrews, the United Nations special rapporteur on human rights in Myanmar, said on Wednesday.

Public anger toward the army — which has already shot dead hundreds of people protesting the coup, as well as children and other bystanders — has only hardened.

In other news around the world:

  • Singapore reported a new cluster of infections at karaoke bars, driving the city-state’s biggest daily surge in cases in 10 months. Health officials closed several karaoke lounges, known locally as KTV, and asked anyone who had visited those or similar establishments in recent weeks to come forward for testing or to isolate for 14 days. Singapore recorded 60 cases on Wednesday, but officials said that there were no immediate plans to reintroduce social restrictions because of the growing rate of vaccinations. More than 70 percent of people in Singapore have received at least one dose.

  • The United States is beginning to ship 3.5 million doses of the Johnson & Johnson vaccine to the Philippines on Thursday, according to an assistant White House press secretary, Kevin Munoz. The announcement came a day after Jen Psaki, the White House press secretary, announced that the country was beginning to ship 1.5 million doses of the Moderna vaccine to Sri Lanka.

  • Britain may have overpaid more than $11 billion in welfare payments as fraud and error reached record levels during the first year of the coronavirus pandemic, the government’s spending watchdog said on Thursday, according to Reuters. Fraud levels rose as normal verification checks were suspended in order to process new benefit claims from those who lost work in the country’s lockdown last spring, the spending watchdog said.

  • Deaths in England from liver disease linked to excessive drinking jumped by an unprecedented 21 percent last year, when the coronavirus pandemic struck, as the heaviest drinkers consumed more alcohol at home, official data showed on Thursday, according to Reuters.

  • Thousands of protesters in France and Greece marched in protest on Wednesday, two days after the authorities in both countries announced that shots would soon be mandatory for health workers.

More than 250,000 flags were planted outside the D.C. Armory last fall, to memorialize the U.S. Covid death toll at the time. The toll has more than doubled since, and the artist who created the first installation, Suzanne Brennan Firstenberg, is creating a new one for this fall that will see more than 600,000 flags planted along the National Mall.  
Credit…Stefani Reynolds for The New York Times

Hundreds of thousands of white flags will be planted along the National Mall in Washington in September to memorialize the more than 600,000 people who have died from Covid-19 in the United States.

For two weeks, from Sept. 17 to Oct. 3, the installation, “In America: Remember,” will blanket 20 acres of federal park land near the Washington Monument, and those who have lost someone to the pandemic will be able to submit dedications for the flags.

The artist who announced the project on Thursday, Suzanne Brennan Firstenberg, planted 267,000 flags in Washington last fall to recognize what was then the death toll of Covid in the United States.

The pandemic has since taken hundreds of thousands of additional lives, and the coming installation will more than double the number of flags. The memorial will also be spread across a more prominent location: along the National Mall and bordering the White House, the Washington Monument, the National Museum of African American History and Culture and the World War II Memorial.

Ms. Firstenberg said that an observer standing on the Truman Balcony at the White House would see a “blanket of white” in front of the Washington Monument.

Placing the installation next to the African American history museum was an intentional choice, Ms. Firstenberg said. People of color were disproportionately affected by the virus throughout the pandemic, largely because of social inequality. Black Americans were far more likely to become infected, more than twice as likely to die from it, and had a harder time getting vaccinated.

“Inequity is at the core of why communities of color have been disproportionately affected by this,” Ms. Firstenberg said, explaining that she planned to plant the first flags “in the shadow” of the museum.

She said that she was compelled to create the installation because of her outrage toward public officials who sought to downplay the growing death toll as “just a statistic.” Now, she added, the second iteration of the installation was meant to encourage hesitant Americans to get vaccinated.

“The last thing I want to do is to have to buy any more flags,” Ms. Firstenberg said. “And the best way to do that is to get vaccinated.”

A researcher checking a chicken at a farm in Xiangyang, China, in 2017. The H5N6 virus is one of several potentially dangerous types of flu found in poultry or wild birds.
Credit…China Stringer Network, via Reuters

A man has been hospitalized in southwestern China after contracting the H5N6 strain of avian flu, Chinese state news media reported on Thursday, a reminder that the world is full of flu viruses even during a coronavirus pandemic.

The man, 55, was hospitalized in Bazhong, a city in the southwestern province of Sichuan, after coming down with a fever and testing positive for the virus on July 6, the state-run China Global Television Network reported.

Local officials had “activated an emergency response and sterilized the area,” the broadcaster said in a brief report in English. It cited unnamed experts as saying that the risk of large-scale transmission among humans was low. The report did not provide other details or say whether the man handled poultry as part of his job.

The H5N6 virus is one of several potentially dangerous flu versions that scientists have reported finding over the years in poultry flocks or in captured or dead wild birds. It was first detected eight years ago in Laos, and later spread to China and other countries.

As of last week, 32 confirmed cases of human infection with the H5N6 virus, and 19 deaths, had been reported to the World Health Organization in Asia since 2014, according to the agency. The last human case before the one from Sichuan Province had an onset date of May 13.

Because flu viruses mutate a lot in nature, scientists try to monitor them closely for signs that they are becoming more contagious or deadly. Last year in China, for example, a team of scientists reported that a new strain of the H1N1 swine flu virus was spreading silently in workers on the country’s pig farms and should be “urgently” controlled to avoid another pandemic, even though the strain had not caused disease in the people it infected.

The Yankees and the Red Sox were on the field and preparing for a game Thursday when they learned it had been postponed.
Credit…Adam Hunger/Getty Images

Two and a half hours before the scheduled start time, just after the Yankees had hurriedly pulled the team off the field and canceled batting practice, M.L.B. postponed a game with the Boston Red Sox because three Yankees pitchers had tested positive for the coronavirus.

The three — Nestor Cortes Jr., Jonathan Loaisiga and Wandy Peralta — are all vaccinated.

General Manager Brian Cashman said three other players had tested positive through multiple rapid tests, and that the team expected those players’ laboratory tests to also come back positive.

The Yankees have reached the 85 percent vaccination rate M.L.B. requires to operate under relaxed Covid protocols, but Cashman said the team had again experienced breakthrough cases, two months after an outbreak of nine cases, mostly within the coaching staff.

The Yankees put Loaisiga on the Covid-19 injured list on Saturday in Houston, and he did not travel with the team after that series, which led into the All-Star break. Cortes and Peralta were placed on the list on Thursday.

Cashman did not know the status of the Yankees’ remaining weekend games with the Red Sox, who are scheduled to be in New York through Sunday. Given the two outbreaks the team has now experienced, he said the Yankees would consider a change in protocols.


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